Análisis comparativo entre nefrolitotomía percutánea y ureteroscopia flexible en litiasis renal de 2-3 cm

Abstract

IntroductionTo compare percutaneous nephrolithotomy and flexible ureterorenoscopy for treating kidney stones between 2 and 3cm. Material and methodsA prospective, comparative, nonrandomised study was conducted with 108 patients with kidney stones between 2 and 3cm. Fifty-four patients underwent percutaneous nephrolithotomy and 54 underwent flexible ureteroscopy. We compared the following variables: lithiasis-free rate (%), surgical time, the need for an auxiliary process, postoperative complications, hospital stay, readmission rates and recovery time. ResultsThere were no differences in the lithiasis-free rate between the 2 surgical techniques (76% for ureteroscopy vs. 87% for nephrolithotomy; P=.1) or in the complications (29% for nephrolithotomy vs. 27% for ureteroscopy; P=.4). A larger number of auxiliary process were needed for the ureteroscopy group (20%) than for the nephrolithotomy group (7%) (P=.04).The surgical time was longer for the nephrolithotomy group (121±52min) than for the ureteroscopy group (93±42min) (P=.004).The ureteroscopy group had shorter hospital stays (2.1±1.6 vs. 3.9±1.9 days; P=.002), shorter convalescence (8.1±4.9 vs. 13.3±4.2 days; P=.005) and higher readmission rates (7.4% vs. 0%, P=.05) than the nephrolithotomy group. ConclusionsNephrolithotomy and ureteroscopy have similar efficacy for treating kidney stones measuring 2-3cm, with no differences in complications.Ureteroscopy results in shorter hospital stays, quicker recoveries but more readmissions and a greater need for auxiliary procedures.